Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

Amoakoh-Coleman, Mary; Klipstein‐Grobusch, Kerstin; Agyepong, Irène Akua; Kayode, Gbenga A; Grobbee, Diederick E.; Ansah, Evelyn

doi:10.1186/s12884-016-1167-6

Cited by 30 publications

(52 citation statements)

References 50 publications

(45 reference statements)

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“…The incidence of PIH and PPH is about 4.7% and 3.7% respectively in this study. This study is different from a Ghana study which is 5.3% and 2.1% respectively for PIH and PPH (3). The variation of these results might be because of the time of study and nature of the countries.…”

Section: Incidence Of Maternal and Neonatal Complicationcontrasting

confidence: 92%

“…Incidences of those two maternal complications among the exposed and non-exposed groups were 1.6:6.2 and 2.6:4.3% respectively. ( Table 3) In this study the overall antenatal complication was about 21% which is lower than the study conducted in Ghana where antenatal complication was 68.1% (3).This variation could be due to the programme and follow up implemented now in every country is strict and Ethiopia is one of the nations which follow this agendum. That might be the reason why antenatal complication is reduced.…”

Section: Incidence Of Maternal and Neonatal Complicationcontrasting

confidence: 51%

“…Adherence to the standard guidelines plays an important role in ensuring the uniformity of clinical services and overall in improving the health status of the clients based on their specific needs (3).…”

Section: Introductionmentioning

confidence: 99%

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Adherence level of Health care Providers to first visit antenatal care guideline and its effect on perinatal outcome in Tigray public Health institutions, 2017/18: Cohort study

Melkamu

Hailu²,

G/micheal

et al. 2020

Preprint

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Background: Antenatal care is one of the medical services delivered to pregnant women for the safety of the mother and the neonate. Guidelines are developed to ensure quality, uniformity and consistency of care for clients. One of the guidelines is focused antenatal care. Despite this fact, there is a paucity of information regarding the adherence of health professionals in the implementation of the guidelines and its effect on the perinatal outcomes. Objective : To assess adherence level of health care providers to first visit antenatal care guidelines and its effect on perinatal outcomes among mothers in Tigray Public health institutions in 2017/18. Methods : Cohort study design was employed with sample size of 1545. Among the participants 501(496 with complete follow up) were recruited to exposed groups and 1044 for non-exposed groups. The ratio of exposed to non-exposed group was 1:2. In the selection of study sites simple random sampling method was used but to select study participants consecutive sampling technique was employed. Women with full adherence to the first antenatal guideline were considered as exposed group, whereas those with incomplete adherence were considered as non- exposed group. It was assumed that the risk of complication among the non-exposed group was twice as that of the exposed group. Data was entered to Epi data version 3.51 and exported to SPSS version 20 for further analysis. Binary logistic regression was employed to determine the associated factors and multivariable analysis was done to control the confounding factors and significance was declared at CI of 95% and p-value of <0.05. Relative risk was used to express the association and effect of adherence on the perinatal outcome. Result: Overall, the level of complete adherence to antenatal care guideline was 32.2% .The risks of antenatal, intranatal and neonatal complication was 21%, 41.3% and 26.8% respectively. The risk of maternal and neonatal complication is higher in non-exposed groups, pregnancy induced hypertension and postpartum hemorrhage risks were 1.6%:6.2% and 2.6%:4.3% among exposed and non-exposed groups and a neonatal complication of low birth weight and preterm labor was 5.8%:8.2% and 6.7%:8% among exposed and non-exposed groups respectively. Effect of complete adherence was found to be significant in reducing maternal and neonatal complications. Neonatal complications, anemia, postpartum hemorrhage and early neonatal death was reduced by 40% among the women with complete adherence, maternal sepsis and neonatal sepsis were reduced by 60% among the exposed groups and pregnancy induced hypertension was reduced by about 70% in women with complete adherence. Conclusion and recommendations: Overall providers’ complete adherence to antenatal care guideline at first visit influences both maternal and neonatal outcomes. On average the risks of developing antenatal, intranatal and post natal complications were reduced by almost 50% among the exposed groups. The Federal Ministry of Health and teaching institutions should capacitate their staff to strictly adhere to the implementation of the guidelines Key words: antenatal, adherence, perinatal outcome, providers

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Section: Incidence Of Maternal and Neonatal Complicationcontrasting

confidence: 92%

Section: Incidence Of Maternal and Neonatal Complicationcontrasting

confidence: 51%

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Adherence level of Health care Providers to first visit antenatal care guideline and its effect on perinatal outcome in Tigray public Health institutions, 2017/18: Cohort study

Melkamu

Hailu²,

G/micheal

et al. 2020

Preprint

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“…Several studies have reported the usefulness of treatment guidelines in general and for speciic diseases notably epidemics such as HIV and noncommunicable diseases [3][4][5][6]. In summary, treatment guidelines and algorithms for management of speciic diseases and conditions: Unfortunately, with regard to poisoning incidents, national treatment guidelines of several countries have shortcomings as guidance and algorithms on speciic poisoning agents are not presented there in [7].…”

Section: Importance Of Guidelines and Algorithms In Diagnosis And Manmentioning

confidence: 99%

Introductory Chapter: Linkages Between Clinical and Forensic Toxicology

Malangu¹

2017

Poisoning - From Specific Toxic Agents to Novel Rapid and Simplified Techniques for Analysis

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Additional information is available at the end of the chapter Overview on interconnections between sciences and professionals in case of poisoningPoisoning, whether acute or chronic, and whether accidental or deliberate, is one of the major causes of morbidity and mortality worldwide. International data gathered by the World Health Organization (WHO) suggest that at least an estimated over 100.000 people died worldwide from poisoning every year [1]. Of the factors contributing to this high loss of lives, is the misdiagnosing of poisoning due to lack of qualiied personnel and lack of appropriate medical equipment for conducting relevant investigations.Strictly speaking studying poisoning incidents, how they occur, their symptoms and signs, the toxic agents involved, the diagnosis and management thereof as well as the outcomes of treatment, is a multi-disciplinary endeavour that requires skills and competences in injury epidemiology, clinical and forensic, or analytical toxicology.

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“…Using guidelines during clinical practice has several bene ts for both the provider and end service users. These bene ts include improving client outcomes, ensuring uniformity of care, improving the process and structure of care, and helping providers to make clinical decisions (4)(5)(6)(7)(8).…”

mentioning

confidence: 99%

Provider-Perceived Benefits and Constraints of Complete Adherence to Antenatal Care Guideline Among Public Health Facilities, Ethiopia: A Qualitative Study

Seyoum

Alemayehu

Christensson

et al. 2020

Preprint

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Background: In Ethiopia, health care providers’ level of adherence to the national Antenatal Care (ANC) guideline is relatively low. The reasons why they do not follow the guidelines are not well known. Therefore, this study aimed to explore the provider-perceived benefits and constraints associated with using the guideline for ANC in public health facilities in Gondar town.Methods: A qualitative study was conducted using a semi-structured interview guide. The interview was conducted among a purposive sample of nine health care providers working in four public health facilities in Gondar town. After the interviews were transcribed and coded, a content analysis was done using Atlas ti version 7.5 software packages.Result: Decreasing provider’s workload and maximizing performance, improving safe motherhood, and improving the process of service delivery were reported as the perceived benefits of following ANC guideline. Organizational problems, care providers' existing knowledge, attitude, and skills and availability of training and mentorship were the three main identified groups of factors that hinder complete providers’ adherence to ANC guideline.Conclusion: Although providers acknowledged the benefits of following ANC guideline, the guideline is not fully implemented. Refresher training should be given at the start of the updated eight-contact ANC guideline and continuing education and supervision throughout the implementation process. Health care providers call for profound and urgent revisions of the supply chain system for supplies and equipment.

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Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

Cited by 30 publications

References 50 publications

Adherence level of Health care Providers to first visit antenatal care guideline and its effect on perinatal outcome in Tigray public Health institutions, 2017/18: Cohort study

Adherence level of Health care Providers to first visit antenatal care guideline and its effect on perinatal outcome in Tigray public Health institutions, 2017/18: Cohort study

Introductory Chapter: Linkages Between Clinical and Forensic Toxicology

Provider-Perceived Benefits and Constraints of Complete Adherence to Antenatal Care Guideline Among Public Health Facilities, Ethiopia: A Qualitative Study

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